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Clinical research of two anaesthesia methods in gynaecologic laparoscopic surgery

Objective: To compare the clinical efficacy and complications between epidural block combined with intravenous general anaesthesia and laryngeal mask combined with spinal epidural anaesthesia.

Methods: 70 cases of patients with Gynaecologic Laparoscopic Surgery from February 2013 to February 2015 were grouped randomly to two groups, including epidural group (Group I) and laryngeal mask (Group II), each group enrolled 35 patients. Group I utilized epidural block combined with intravenous general anaesthesia, Group II used laryngeal mask combined with spinal epidural anaesthesia. The data of HR, SpO2, PET CO2 and MAP were recorded and compared before anaesthesia and at the 5 min, 20 min, and 45 min after pneumoperitoneum and 10 min after bleeding. Anaesthesia complications were also observed, to compare the effect of pneumoperitoneum on the respiratory function, circulatory function and complications in between the two groups.

Results: The interference after pneumoperitoneum in Group II was bigger than that in Group I, SpO2 decreased, Pet-CO2 increased. In group I, the HR was significantly accelerated, BP was significantly increased (p<0.05), and was significantly higher than group II (p<0.05) at the time of intubation, extubation and 5 min after extubation.

Conclusion: Due to epidural block combined with intravenous general anaesthesia could significantly reduce the stress reaction induced by pneumoperitoneum, less anaesthesia complications, smooth intraoperative blood flow. However, the laryngeal mask with combined spinal epidural anaesthesia for gynaecological laparoscopic surgery was also a safe and feasible method, because the general anaesthesia therapy dose are few than that in epidural group.

Author(s): Chunlei Zhang, Yanhong Wang, Ling Qin, Shuhuan Guo